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August 1997 


In this issue: 

•Facing fax 
•Parking options 
•CFO named 



Board recommends CC budget, 
hears reports on strategic plan 


Projects serve up 
an era of change 
for building 10 

The face of the Clinical Center is 
about to change forever. 

First up is construction of the 
south entry, which will serve as the 
CC’s main front door for the 
duration of the project. That begins 
this month. 

“Actual construction of the new 
entry and drive should be 
completed by April 1998,” noted 
Yong-Duk Chyun, CRC project 
director for NIH. “Between April 
and August of next year, associated 
mechanical work will be 
completed.” 

Construction of the new 
building to the north will begin in 
October. Initial site preparations 
include demolition of building 20, 
relocation of utilities, and 
realignment of Center Drive. That 
work will continue until next June, 
when actual excavations will get 
under way. 

All these construction phases 
will have specific consequences for 
campus parking, officials note. 

(See story on parking, page six.) 

Watch for signs specifying what 
construction involves and how it 
will affect parking and building 
access. Other communications 
efforts are planned. “We want to 
make sure that everyone is kept 
informed about the project and how 
it will affect day-to-day 
operations,” Chyun explained. 


The Clinical Center’s Board of 
Governors unanimously voted to 
recommend approval of the CC’s 
$224 million budget for FY98 during 
their meeting here July 10. It goes 
next to Dr. Harold Varmus, NIH 
director, for his consideration. 

Personnel costs consume most of 
the proposed budget pie. “Total 
personnel costs for ‘98 are $136.7 
million or 61 percent of the budget 
when both contract and government 
FTE costs are included,” Dr. John 


Gallin, CC director, pointed out. 

“The contract service element, 
which is 17 percent of the total 
budget, is the next major expenditure 
and it’s made up of all the 
maintenance contracts for sustaining 
equipment, repairs, utilities, plant 
maintenance, and off-campus rental 
facilities.” 

The budget also sets aside $32.1 
million for supplies and $5.8 million 

See board meeting, page seven 



A towering profession 

George Simmons (left) operates one of the tower cranes that’s been looming over the 
Clinical Center for the past few months. NIH staff physician Dr. Alan Zametkin (right) 
wanted to know more. See pages four and five. (Photo by Bill Branson) 




from the director 


by Dr. John I. Gallin 
CC director 

At NIH, Boards of Scientific 
Counselors review our science. They 
assess research that’s proposed and in 
progress. They evaluate the 
productivity and performance of staff 
investigators. The purpose is to make 
sure that research at NIH is efficient 
and of the highest possible quahty. 

Similarly, we at the Clinical 
Center need a formal mechanism to 
take a long, hard look at our 
operations and how we function as an 
organization in order to be efficient 
and productive while preserving the 
quahty of science and research. That 
is why I have proposed a new 
departmental review process to the 
CC Board of Governors that will help 
CC departments evaluate and 


Co-workers, family, and Mends of 
the late Jesse J. Ferguson crowded 
into Masur Auditorium on July 8 for 
a service in his memory. 

Ferguson died days before his 
planned retirement from federal 
service. A native of Nacogdoches, 
Texas, he began his federal career at 
the Chnical Center in 1961. He 
began with the local-transportation 
section, working through the ranks 
serving as chief of the patient escort 
service, chief of the admissions 
section and as chnic administrator, 
and deputy chief of the Outpatient 
Department. 

Although he hved in the 
Washington area for nearly 40 years, 
Ferguson, the memorial program 


improve their individual operations. 

My goal is to have a very frank 
and constructive review process of 
the operational aspects of each 
department to find out what is 
working well within the Clinical 
Center and what needs fixing. 

I’ve proposed a rotating schedule 
of reviews that would ensure a top-to- 
bottom survey of departmental 
performance once every three years. 

The survey team will include 
internal and external experts 
experienced in the individual areas 
they will survey. Users of 
departmental services may be 
included on the team and certainly 
will be able to provide input. A 
member of the Board of Governors 
will head the group. 

The Chnical Center’s new chief 
financial officer, Michele Lagana, 


noted, remained a Texan at heart and 
was a devoted Dallas Cowboys fan. 

“He dedicated himself to the 
patients and mission of the Clinical 
Center and his zeal to ensure 
compassionate, efficient patient care 
guided his every action. He could be 
found at work days, nights, 
weekends, and hohdays, sometimes 
in his white lab coat, others in his 
baseball cap and bib overalls.” 

He also found time to volunteer 
with D.C. youth programs and he 
coached youth and men’s football 
teams. 

Those wishing to make 
conMbutions to a memorial fund 
may contact Nancy Schulze or 
Grade Millender in the Outpatient 


(See story page eight) is leading a 
team of CC and NIH staff to refine 
our structure of review, define how to 
use the information we discover, and 
develop and evaluate subsequent 
efforts to improve department 
performance. 

Evaluation results will be 
presented to the Board of Governors. 
One of the board’s charges is to 
evaluate the performance of the 
Clinical Center. How well 
departments work in serving NIH’s 
patient-care, research, and 
administrative needs is a critical 
element of that performance. 

The Clinical Center has never 
had a process in place to conduct this 
systematic review of department 
operations. I beheve this will be a 
constructive and valuable process for 
us all. 



Memorial services were held last month 
for Jesse Ferguson, a long-time CC 
employee. 


Department. The phone number is 
496-2341. The memorial fund will 
benefit youth programs at the 
Lamond Riggs Community Center. 


Long-time CC employee dies just 
before retirement; memorial held 


Clinical Center 


Editor: Sara Byars 


Staff Writer: Sue Kendall 


-y- L Him ai L nun 

News 


Clinical Center News, Building 10, Room 1C255, National Institutes of Health, 
Bethesda, Maryland 20892. (301) 496-2563. Fax: 402-2984. Published monthly for CC 
employees by the Office of Clinical Center Communications, Colleen Henrichsen, chief. 
News, article ideas, calendar events, letters, and photographs are welcome. Deadline for 
submissions is the second Monday of each month. 




2 Clinical Center News August 1997 


the fax, please 


Fax your comments, 
questions, observations, and 
ideas about making the 
Clinical Center a better place 
to work to: 
402-2984. 

We’ll include the feedback 
and responses from the CC 
director In future Issues. No 
names will be used. 


optional info: 


Name: 


Fax/phone/email 


answers 


Last month’s reminder of the Clinical 
Center’s smoking policy prompted 
the following comments from 
readers: 

From a staff member: On numerous 
occasions I have noticed people 
smoking in front of the Clinical 
Center and the police officer on duty 
doing nothing about it. Are you 
serious about enforcing the smoking 
policy? Signs have been installed but 
some people — sometimes 
patients — can’t read or choose to 
ignore the no-smoking signs. I, for 
one, would appreciate stricter 
enforcement. Let’s practice what we 
preach. 

From a staff member: I’ve been 
working in the NIH library for the 
last five years. I think the July 1995 
restriction on smoking around the CC 
has done very little to curb the 
horrible smell of smoke creeping into 
the hallway outside the library, and 
consequently the library itself. The 
main reason, I believe, is the lack of 
any security enforcing the law. 


Smokers, especially patients and non- 
staff persons, constantly light up right 
outside the entrance and sometimes 
even inside. The main issue, get some 
security presence in the back of 
building 10, start seriously enforcing 
the smoking restrictions outside the 
hbrary, push the smokers outside 
from under the canopy and the 
overhang outside the cafeteria. Make 
this truly the National Institutes of 
Health. 

From a patient: I’ve been a patient 
here for nine years and appreciate aU 
the good work that goes on here. I 
sometimes think that the smoking- 
related littering is in part a protest on 
the part of the smokers. We haven’t 
been provided with ash receptacles so 
that we can properly dispose of the 
smoking litter and there’s no 
comfortable, protected seating 
provided to encourage smokers to 
move away from the building. 

The CC director responds: 

Asking for NIH police assistance 
in enforcing our smoking policy is an 


avenue that I will pursue with NIH 
and police officials. Signs indicating 
where smoking is not permitted are in 
place and we’ll add more as needed. 
Ash receptacles are located along the 
perimeter of the building. If more are 
needed in different places, fax the 
suggested locations to 402-2984. 

Unfortunately for smokers, 
however, the Clinical Center will not 
provide amenities such as shelter and 
seating for staff and visitors who 
choose to smoke. 

Our policy is clear — don’t smoke 
within 100 feet of any entrance or 
posted no-smoking area. Smoking is 
not allowed in the parking garage or 
in stairwells. When smokers do not 
comply with this pohcy, smoke is 
drawn into the building creating 
unhealthy and unpleasant conditions 
for everyone. 

Out of consideration for our 
patients and st 2 iff, we ask that smokers 
respect these rules and that they not 
litter our grounds with smoking- 
related trash. 


August 1997 Clinical Center News 3 




George Simmons’s view from the top 
offers a panorama of the NIH campus. 
He’s a tower crane operator and 
spends work days towering over the 
Clinical Center. (Photos by Bill 
Branson) 



Crane operator's office is a room with a view 


Editor’s note: For months Dr. Alan 
Zametkin, NIH staff physician, 
watched an astounding variety of 
materials float up and down past his 
fourth floor office window. Steel 
beams. Buckets of concrete. Carts 
full of trash and debris. “Given that 
these exceedingly heavy objects 
have passed within two to three feet 
of my window, I wondered who was 
in fact hauling this vast array of 
materials so close to my enclave in 
the Clinical Center,” he explained. 
“Many people at NIH — including 
me — have marveled at the precision 
and skill that these crane operators 
have. I wanted to know more.” He 
had an opportunity to find out more 
about the man behind the machine 
just after sunrise one summer 
morning and shares the story with 

CCNews. 


4 Clinical Center News August 1997 


For many, it takes years to climb the 
ladder to the top of NIH. George 
Simmons does it in about five 
minutes a day, five days a week. 

Sinunons is a tower crane 
operator for Clark Construction 
Company. The crane he operates 
towers over the Clinical Center’s east 
wing. It’s one of two 270-footers put 
into place late last year as part of the 
NIH Essential Maintenance and 
Safety Program. The Clinical 
Center’s wings are having their roofs 
raised to allow installation of new 
air-handling and safety systems. 

A tower crane operator for 17 
years, Simmons moves hundreds of 
tons of massive and unwieldy 
building materials between narrow 
canyons of building walls to the top 
of the Clinical Center. 

Simmons’s touch at the crane’s 
control panels hasn’t always been as 
deft and true as it is today. “I began 
operating heavy machine equipment 
after graduating from high school,” 
he said. “My father operated cranes 
and heavy equipment, too.” During a 


lunch break one day, the young 
worker accepted an invitation to 
climb a crane tower for the first time. 
He recalls clinging to the ladder with 
such intensity that his hands literally 
ached — the classic white-knuckle 
syndrome. He was absolutely 
petrified. 

But he persisted and gradually, 
after several more climbs, the fears 
and anxieties were put to rest. An 
apprenticeship set him on his way as 
a professional tower crane operator. 

In those early days, Simmons worked 
slowly and hadn’t developed his 
precise skills in placing the crane’s 
hook. Co-workers pouring concrete 
in 100-degree heat were not inclined 
to silently and patiently wait for 
Simmons to hone those skills. 

“One guy told me in no uncertain 
terms that I should go home and 
never come back,” Simmons recalled. 
And he almost followed that advice. 
“For the first month, I hated the job 
and swore I wouldn’t continue.” But 
he did continue, mastering the 
delicate controls of the tower. 


L 




(Left) A ladder zig-zags up the 270-foot tower crane that George 
Simmons operates. (Above) His base of operations is a cozy blue 
cab that puts a chorus of controls at his fingertips. 


Work atop the Clinical Center, he 
says, is actually much slower paced 
than the usual construction job 
because the work doesn’t involve 
constructing a building from the 
ground up. “At other jobs, we may go 
two or three weeks working straight 
through the days without even a lunch 
break,” he said. During peak periods 
of construction activity, the tower 
crane operator’s skills and talents are 
in demand as many as twelve hours a 
day. 

Tower cranes, which rent for 
about $10,000 a month, have 
dramatically changed the construction 
industry over the years, Simmons 
pointed out, because they allow rapid 
placement of huge amounts of 
building materials. They appeared on 
the construction scene in the mid- 
1960s. 

Extremely bad weather usually 
means a temporary construction halt 
for most projects, but it takes more 
than a stiff breeze and a little thunder 
to bring Simmons down from his 


perch. The crane is grounded and can 
take winds of up to 45 miles an hour. 

The crane’s long arm — jib — isn’t 
locked into place at night and freely 
moves in the wind acting like a 
tremendous weather vane. When 
Simmons is on board the crane, it, by 
design, can sway as much as five feet 
at the top. The crane’s will flex up to 
10 feet, depending on the load being 
carried. Sometimes Simmons has to 
walk out to the end of that arm for 
inspections and maintenance. 

Because safety is at the top of 
every crane operator’s agenda, close 
calls are rare. Simmons remembers 
one while he was on another job. His 
shirt accidentally caught on one of his 
crane’s control levers, sending the 
crane’s trolley out over the building 
they were working on. It snagged a 
construction worker, who scrambled 
to attach his safety harness to the 
crane’s hook. When he realized what 
was happening, Simmons quickly 
lowered the snagged worker to safety. 

Then there are the lighter 


moments. Like the time Simmons 
was working on a job in Washington, 
D.C., hoisting materials off a 13- 
story building guided only by radio 
directions from co-workers on the 
roof. 

One item was a toilet that needed 
to go curbside for cleaning. “The 
signal man on the roof said, by radio, 
that the cleaning was finished and to 
take it back to the roof.” But the 
cleaning wasn’t finished and the man 
doing it was still inside. He made it 
about 11 floors up before his 
screaming tipped off the crew and he 
was sped safely back to ground level. 

From a distance, we’ve admired 
the skills and coordination of these 
men behind the machines. Up close, 
their professionahsm is impressive. 
And we appreciate the efforts of the 
entire construction team that allow us 
all to continue our work here into the 
next century. 

— by Dr. Alan Zametkin 


August 1997 Clinical Center News 5 




Construction takes toll on 
already-tight parking; 
campus officials outline options 


Looking for a place to park? Well, so 
have NIH planners. 

Beginning this month, campus 
construction will have an increasing 
effect on parking — or the lack of 
it — and campus officials are plotting a 
multi-level course of action to deal 
with it. Work associated with the new 
south entry for the Clinical Center and 
relocation of Center Drive in 
preparation for CRC construction will 
have major impact. 

“This isn’t ‘new’ news,” points 
out Stella Serras-Fiotes, master 
planner in the Division of Engineering 
Services, facilities planning and 
programming branch, a part of the 
NIH Office of Research Services. “We 
have been working on the parking 
plan with these losses in mind.” 

Recently opened temporary lots 
have already provided some relief. 
They are located south of lot 41B; in 
front of the Cloister; near Natcher; by 


the electrical power station at 
building 17 (near the Metro); and at 
NLM . “With the completion of 
temporary parking lots, we’ve 
actually added 100 more spaces than 
the 300 parking spots that were lost 
when parking lot 13C closed earher 
this sununer,” Serras-Fiotes said. 

Here’s what’s ahead for August: 

•All campus visitor parking will 
be consolidated Aug. 4 in four pay- 
for-parking facilities with 
attendants — the temporary lot at 
Natcher, the top two-and-a-half levels 
of MLP-8, part of lot 4A (between 
buildings 1 and 31), and the P3 level 
of the parking garage. In P3, there is 
no parking charge for patients, 
visitors to patients, and other 
authorized users. Other current visitor 
parking will be reassigned to 
employees (MLP-6, lot 4 IB and C, 
lot 3 IE). 

•Parking meters — 135 of 


them — will be installed near building 
13, 36, 38, and Natcher. 

•Attendant-assisted parking will 
be instituted for employees who park 
on the lower levels of MLP-8. 

Construction personnel will no 
longer be able to park in lot 4 IB. 
They will have to park off campus, 
which frees up another 150 spaces 
for employees. 

In September expect: 

•Parts of lot lOH, south of the 
CC’s library entrance, will be closed 
in three phases as work begins on the 
Clinical Center’s new south entry. 
“The lot will have to be reconfigured 
to allow for the modified traffic 
circulation patterns associated with 
the new entry,” explained Serras- 
Fiotes. 

Between Sept. 2 and Oct. 13, 
work will be along the entire west 
side of the parking lot. The second 
phase, expected to continue until 
Nov. 24, will involve the north side 
of the lot. The final phase, covering 
the east and southeast edges, should 
be complete just after the first of the 
year. During the first and third 
phase, about 75 spaces will be lost; 
up to 140 during the second phase. 

•When work to relocate Center 
Drive begins in September, lots 20A 
and B — 170 spaces — will close. 

On tap for October: 

•Lot 20C will close. Strike 
another 100 parking spots. 

•Lot IOC, which is between 
buildings 10 and 49, will lose about 
50 spaces in mid-October as the NIH 
utihty tunnel project continues. 

•Lots 31A-H are slated to become 
attendant-assisted parking areas, 
which will increase capacity for 
employees by about 330 spaces. 

“Since the CC is particularly 
hard hit by the loss of campus 
parking, we’re considering an option 
to provide attendant-assisted parking 
for employees at levels PI and P2 of 
the garage, which could increase the 
capacity by at least 200 spaces,” 
Serras-Fiotes said. That plan would 
have to wait until completion of 
repairs to the PI ramp, expected to 
begin in mid- August and continue 
through the end of October. 


6 Clinical Center News August 1 997 


. . . board meeting covers budget, strategic pian 


(Continued from page one) 

for independent CC research. Another 
$7.7 million is earmarked for new 
equipment, including: 

•$100,000 for development of a 
new molecular diagnostics lab in the 
Clinical Pathology Department, 
which is in collaboration with NCI 
and NHGRI. 

•$125,000 for an echocardiogram 
for Critical Care Medicine. 

•$2.55 million for a new 1.5 Tesla 
magnetic resonance scanner for the 
Diagnostic Radiology Department. 

•And, $1.6 million for 
Information Systems Department 
hardware, software and hcenses, and 
telemedicine development. 

The FY98 budget reflects 
essentially the same level of funding 
as provided in the current budget, a 
continuing commitment by Dr. Gallin 
to maintain the quality of services 
within limited ICD budgets. 

About $2.7 million was added to 
the original $221 million in FY97 


The FY98 budget 
reflects essentially the 
same level of funding as 
provided in the current 
budget . . . 

with the transfer of two labs to the 
Clinical Center. They are the 
Laboratory of Diagnostic Radiologic 
Research, previously a part of the 
NIH Office of Intramural Research, 
and the Multi-Modality Radiologic 
Imaging Process Systems from 
NCRR. 

In his update to board members. 
Dr. Gallin outlined four new projects 
being developed under the umbrella 
of the CC’s strategic plan. 

“I challenged the department 
heads during our March retreat to 
come up with ways to identify cost 
savings in our budget by being 
creative. The outcome of the retreat 


was to modify our strategic plan to 
include four new projects — contract 
assimilation; management tools; 
incentives development; and 
procurement savings.” 

Major elements for each include: 

•Contract Assimilation — 
conversion of selected large contracts 
to in-house operations to save money 
without compromising the quality of 
care and support offered to the 
institutes. Contract assimilations 
under consideration are surgical 
services and anesthesiology; 
respiratory care and physiological 
monitoring; PET technicians; and 
secretarial and clerical support for the 
Diagnostic Radiology Department. 
This initiative could generate up to $2 
million in savings. Dr. Gallin told the 
group. 

•Executive information 
systems — a series of related 
initiatives aimed at providing institute 
and CC managers information and 
tools to maximize productivity. A 
contract is in the works to analyze 
what internal management systems 
exist and how they can be enhanced. 
Dr. Gallin noted. 

Linchpin of this project is a cost- 
accounting system. “We’ve never had 
a cost-accounting system here and we 
want to develop a good one, or at 
least evaluate the virtues and cost of 
having a good one,” Dr. Gallin said. 
“We want to be able to accurately 
project the cost of all new protocols 
as they’re developed and then use that 
process to help ICDs track the costs 
as time goes on.” 

•Incentives development — a 
system to reward employees for their 
cost-savings and productivity. “We 
need a system for rewarding 
employees who do a good job in this 
regard.” 

•Procurement — purchasing goods 
at the lowest costs through 
consolidation of maintenance 
contracts, equipment standardization, 
use of the DOD Prime Vendor 
program, and expanded use of 
purchase cards. 



August 1997 Clinical Center News 7 




Lagana named CC’s 
first chief financial officer 


Michele T. Lagana has been named 
chief financial officer for the Clinical 
Center. 

“This is a new position for the 
Clinical Center,” said Dr. John Gallin, 
CC director, in announcing the 
appointment. “Lagana will help us 
develop a cost-accounting system for 
the hospital, which will allow us to 
more closely monitor our budget and 
track costs. It’s central to our efforts 
in giving CC and institute managers 
the information and tools they need to 
enhance productivity and, most 
importantly, to preserve the quality of 
research.” 

“This is an exciting time to be 
joining the CC team,” Lagana said, 
“with the building of the new CRC, 
development of more informative 
financial systems for management 
decision-making, and establishment 


of the new governance structure.” 

Since 1988, Lagana had been 
assistant vice president and controller 
at Providence Hospital in 
Washington, D.C., a 408-bed hospital 
and 240-bed nursing home. 

Prior to that position, Lagana was 
with the Medlantic Health Care 
Management Corporation, also in 
Washington, serving as assistant 
director of financial analysis from 
1976-1987 and assistant director for 
financial planning from 1984-1986. 

Lagana holds a B.A. in finance 
and economics from Towson State 
University and earned the M.B.A. 
from George Washington University. 
She is a member of the Healthcare 
Financial Management Association 
and the Maryland Health Care 
Coalition. 



Michele T. Lagana has been named the 
Clinical Center's first chief financial officer. 
Since 1988, she had been assistant vice 
president and controller at Providence 
Hospital in Washington, D.C. 


august 



Lipsett Amphitheater 

Osteogenic Precursor Cells: 
Utilization for Treating and 
Modeling Bone Diseases, 
Pamela Gehron Robey, Ph.D., 
NIDR 

The Clinical Data 
Repository and Repository 
Access: New Tools for 
Retrieving Clinical Data, 

Tom Lewis, M.D., CC 



Lipsett Amphitheater 

Delay of Epiphyseal Fusion: 
An Experimental Approach 
for Increasing the Height of 
Extremely Short Children, 
Jack A. Yanovski, M.D., 
Ph.D., CC and NICHD 

Schizophrenia in the Age of 
Molecular Science, David 
Pickar, M.D., NIMH 

Note: No Grand Rounds are 
scheduled for Aug. 6 and Aug. 13. 



Bringing the fiag to fiower 

It was February and CC patient Maynard Bartlett wanted a garden. He meticulously 
drew out his plan. Flowers — red, white, and blue — in the shape of the American flag. CC 
staff, patients, volunteers, and friends pitched in to help bring that flag to flower. 
Admiring the work in progress earlier this summer were (from left) James Truell; Cindy 
White, certified therapeutic recreation specialist in the Rehabilitation Medicine 
Department’s recreational therapy section; Jan Hass; Mary Meyer, R.N. on 3 East; and 
Lou Gaeta, also a 3 East staff member. The garden continues to be a cooperative 
effort — Red Cross volunteers help keep it watered and NIH grounds maintenance staff 
loaned garden tools. It’s on the patio east of the CC’s main entrance.